Abstract
Electroencephalography (EEG) monitoring has become technically feasible in daily clinical anesthesia practice. EEG is a sensitive method for detecting neurophysiological changes in the brain and represents an important frontier in the monitoring and treatment of patients in the perioperative period. In this review, we briefly introduce the essential principles of EEG. We review EEG application during anesthesia practice in the operating room, including the use of processed EEG in depth of anesthesia assessment, raw EEG monitoring in recognizing brain states under different anesthetic agents, the use of EEG in the prevention of perioperative neurocognitive disorders and detection of cerebral ischemia. We then discuss EEG utilization in the intensive care units, including the use of EEG in sedative level titration and prognostication of clinical outcomes. Existing literature provides insight into both the advances and challenges of the clinical applications of EEG. Future study is clearly needed to elucidate the precise EEG features that can reliably optimize perioperative care for individual patients.
Highlights
Electroencephalography (EEG) is a non-invasive, relatively inexpensive, and objective method for assessing neurophysiological function
A systemic review of 36 trials with a total of 7,761 highrisk surgical patients identified a lower risk of intraoperative awareness with use of BIS-guided anesthesia compared to clinical sign-guided anesthesia [29]
Patients who received BIS-guided anesthesia had lower rates of postoperative delirium and cognitive decline at 3 months compared to routine care [65]
Summary
Electroencephalography (EEG) is a non-invasive, relatively inexpensive, and objective method for assessing neurophysiological function. A systemic review of 36 trials with a total of 7,761 highrisk surgical patients identified a lower risk of intraoperative awareness with use of BIS-guided anesthesia compared to clinical sign-guided anesthesia [29]. Several other EEG-based depth of anesthesia monitors have been developed and are approved for clinical use.
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